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Informal and Formal Social Integration Shape Eating and Drinking of Older Black and White Americans.

ABSTRACT: Objective: Health behaviors are seen as one possible pathway linking race to health outcomes. Social integration has also been consistently linked to important health outcomes but has not been examined as a mechanism accounting for racial differences in health behaviors among older U.S. adults. Method: We use data from the American's Changing Lives (ACL) Study to explore racial differences in measures of social integration and whether they help account for racial differences in several dietary behaviors and alcohol use. Results: We find differences by race and social integration measures in dietary behaviors and alcohol use. Net of socioeconomic status, health status, and reported discrimination, variation in social integration helps to account for racial differences in some health behaviors. Discussion: Our results highlight the nuanced role of social integration in understanding group differences in health behaviors. Interventions should consider such complexities when including aspects of social integration in their design.

SUBMITTER: Hauschildt K

PROVIDER: S-EPMC7305969 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Informal and Formal Social Integration Shape Eating and Drinking of Older Black and White Americans.

Hauschildt Katrina K Burgard Sarah A SA

Journal of aging and health 20191221 9

<b>Objective:</b> Health behaviors are seen as one possible pathway linking race to health outcomes. Social integration has also been consistently linked to important health outcomes but has not been examined as a mechanism accounting for racial differences in health behaviors among older U.S. adults. <b>Method:</b> We use data from the American's Changing Lives (ACL) Study to explore racial differences in measures of social integration and whether they help account for racial differences in sev ...[more]

PMID: 31868090

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Project description:BACKGROUND:Low levels of total 25-hydroxyvitamin D are common among black Americans. Vitamin D-binding protein has not been considered in the assessment of vitamin D deficiency. METHODS:In the Healthy Aging in Neighborhoods of Diversity across the Life Span cohort of blacks and whites (2085 participants), we measured levels of total 25-hydroxyvitamin D, vitamin D-binding protein, and parathyroid hormone as well as bone mineral density (BMD). We genotyped study participants for two common polymorphisms in the vitamin D-binding protein gene (rs7041 and rs4588). We estimated levels of bioavailable 25-hydroxyvitamin D in homozygous participants. RESULTS:Mean (±SE) levels of both total 25-hydroxyvitamin D and vitamin D-binding protein were lower in blacks than in whites (total 25-hydroxyvitamin D, 15.6±0.2 ng per milliliter vs. 25.8±0.4 ng per milliliter, P<0.001; vitamin D-binding protein, 168±3 ?g per milliliter vs. 337±5 ?g per milliliter, P<0.001). Genetic polymorphisms independently appeared to explain 79.4% and 9.9% of the variation in levels of vitamin D-binding protein and total 25-hydroxyvitamin D, respectively. BMD was higher in blacks than in whites (1.05±0.01 g per square centimeter vs. 0.94±0.01 g per square centimeter, P<0.001). Levels of parathyroid hormone increased with decreasing levels of total or bioavailable 25-hydroxyvitamin D (P<0.001 for both relationships), yet within each quintile of parathyroid hormone concentration, blacks had significantly lower levels of total 25-hydroxyvitamin D than whites. Among homozygous participants, blacks and whites had similar levels of bioavailable 25-hydroxyvitamin D overall (2.9±0.1 ng per milliliter and 3.1±0.1 ng per milliliter, respectively; P=0.71) and within quintiles of parathyroid hormone concentration. CONCLUSIONS:Community-dwelling black Americans, as compared with whites, had low levels of total 25-hydroxyvitamin D and vitamin D-binding protein, resulting in similar concentrations of estimated bioavailable 25-hydroxyvitamin D. Racial differences in the prevalence of common genetic polymorphisms provide a likely explanation for this observation. (Funded by the National Institute on Aging and others.).

Project description:BackgroundRenal cell carcinoma and hypertension (a well-established renal cancer risk factor) are both more frequent among blacks than whites in the United States. The association between hypertension and renal cell carcinoma has not been examined in black Americans. We investigated the hypertension-renal cancer association by race, and we assessed the role of hypertension in the racial disparity of renal cancer incidence.MethodsParticipants were enrolled in a population-based case-control study in Detroit and Chicago during 2002-2007 (number of cases: 843 whites, 358 blacks; number of controls: 707 whites, 519 blacks). Participants reported their history of hypertension and antihypertensive drug use. We used unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for demographic characteristics, smoking, body mass index, and family history of cancer.ResultsHypertension doubled renal cancer risk (OR = 2.0 [CI = 1.7-2.5]) overall. For whites, the OR was 1.9 (CI = 1.5-2.4), whereas for blacks it was 2.8 (2.1-3.8) (P for interaction = 0.11). ORs increased with time after hypertension diagnosis (P for trend <0.001), reaching 4.1 (CI = 2.3-7.4) for blacks and 2.6 (CI = 1.7-4.1) for whites after 25 years. ORs for poorly controlled hypertension were 4.5 (CI = 2.3-8.8) for blacks and 2.1 (CI = 1.2-3.8) for whites. If these estimates correctly represent causal effects and if, hypothetically, hypertension could be prevented entirely among persons aged 50-79 years, the black/white disparity in renal cancer could be reversed among women and reduced by two-thirds among men.ConclusionsHypertension is a risk factor for renal cancer among both blacks and whites, and might explain a substantial portion of the racial disparity in renal cancer incidence. Preventing and controlling hypertension might reduce renal cancer incidence, adding to the known benefits of blood pressure control for heart disease and stroke reduction, particularly among blacks.

Dataset Information

Informal and Formal Social Integration Shape Eating and Drinking of Older Black and White Americans.

Publications

Informal and Formal Social Integration Shape Eating and Drinking of Older Black and White Americans.

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